Objective: To characterize the obstetrical management and outcomes in a series of women with a history of Kawasaki disease (KD) in childhood Design: Retrospective case series Setting: Tertiary healthcare setting in the United States Population: Women with a history of KD in childhood Methods: Subjects completed a detailed health questionnaire and participated in research imaging studies as part of the San Diego Adult KD Collaborative Study. Main outcome measures: Obstetrical management; complications during pregnancy and delivery; infant outcomes. Results: Ten women with a history of KD in childhood carried a total of 21 pregnancies to term. There were no cardiovascular complications during labor and delivery despite important cardiovascular abnormalities in four of the ten subjects. Pregnancy was complicated by preeclampsia and the post-partum course was complicated by hemorrhage in one subject each. Two of the 21 progeny subsequently developed KD. Conclusions: Women with important cardiovascular sequelae from KD in childhood should be managed by a team that includes both a maternal-fetal medicine specialist and a cardiologist. Pre-pregnancy counseling should include delineation of the woman’s current functional and structural cardiovascular status and appropriate adjustment of medications, but excellent outcomes are possible with appropriate care. Review of the English and Japanese literature on KD and pregnancy revealed the occurrence of myocardial infarction during pregnancy in women with missed KD and aneurysms that were not diagnosed until their acute event. Our study highlights the need for counseling regarding the increased genetic risk of KD in offspring born to these mothers.